MEDICARE: NICOLE CHITTUM RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	95225751	CA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95037976	CA

General Provider Information

NPI Number	:	1093530149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE CHITTUM RN

Provider Business Mailing Address
First Line	:	18111 BROOKHURST ST
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-6728
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5331 EL DORADO DR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-4567
Country	:	US
Telephone Number	:	949-775-1785
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2024
Last Update Date	:	04/15/2026

Similar Medicare Providers

1538015193 — FORTITUDE MENTAL HEALTH PROFESSIONAL NURSING CORPORATION
Practice Location Address:

5331 EL DORADO DR
HUNTINGTON BEACH, CA
92649-4567

Practice Phone: 949-775-1785
Practice Fax:

1386763357 — MRS. MARGARET PODLESNY
Practice Location Address:

2403 HUNTINGTON LN SE
DECATUR, AL
35601-4567

Practice Phone: 256-301-1919
Practice Fax:

1972600856 — DR. DINH VAN DINH DO
Practice Location Address:

14281 BEACH BLVD
WESTMINSTER, CA
92683-4567

Practice Phone: 714-893-8800
Practice Fax: 714-893-8810

1558620476 — DR. MARCOS ANTONIO ORDONEZ PHARM D
Practice Location Address:

4567 HOLLY DR
PALM BEACH GARDENS, FL
33418-4501

Practice Phone: 561-827-2262
Practice Fax:

1134577513 — SUCEL TEJEDA BCBA,RN
Practice Location Address:

6660 ESTERO BLVD UNIT B404
FORT MYERS BEACH, FL
33931-4567

Practice Phone: 239-628-6999
Practice Fax:

1588160055 — PERRY LE DINH DO
Practice Location Address:

14281 BEACH BLVD
WESTMINSTER, CA
92683-4567

Practice Phone: 718-893-8800
Practice Fax:

Directions to “ NICOLE CHITTUM RN” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.